[Recommendations for the diagnosis and therapy of vulvovaginitis].
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Biomedical subjects
Publications and source records attributed to K Dvorák.
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We prepared a digital atlas of non-tumourous skin pathology. Currently, the available digital atlases can go beyond the scope of written publications, especially with regards to ease of access, speed of preparation, updating information, fair price and unlimited capacity. This atlas can be used as a diagnostic aid, as well as for postgraduate and pregraduate teaching.
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New sophisticated surgical methods enabled interventions on pancreas which kept remaining without attention of gastrointestinal surgeons for a long time because of previously unsolvable reasons. Pancreatic resection specimens enter now the biopsy diagnostics the correct interpretation of which needs a perfect technology of processing. Biopsy under CT monitoring, fibroscopical techniques combined with contrast investigation, biochemical, cytological and bioptic analyses of samples brought new diagnostic aspects into pancreatic disorders. The authors present a classification analysis based on their group of 172 resection specimens from 165 patients: tumor lesions are represented by 52 specimens, inflammatory lesions by 112 specimens, 8 cases are of another nature or are lacking in a clear diagnostic classification. Bioptic investigation can settle the diagnosis of very rare nosological entities which were distinguished before only in necroptic material (adult nesidioblastosis, Schwachman-Diamond syndrome associated with ductal carcinoma of the head of pancreas, and others).
A teaching database for pathology was prepared comprising around 1250 questions. Five answers belonged to each question, only one of them being correct. Preparation of questions was partly based on testing sets from Medical School of the University of Loma Linda, Ca., partly on those used in 2nd Department of Pathology, Masaryk University Medical School, Brono. In addition, set of computer programmes for automatic generation, printing and evaluation of tests was prepared. They were verified with Brno students.
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Neonatal micropolygyria (MG) was studied concerning a possible proportion of neuroblastic migration in its formal pathogenesis. Section of three selected groups of neonatal brains yielded complete series of frontal histotopograms. Findings were compared with experimental MG induced in the period of neuroblastic migration. Group A: Registration of residual neuroblastic migration in cerebral cortex. There was found that the residual migration could participate on production of MG as late as in the 27th week of gravidity (weight of 1000g). Group B: Evaluation of neuroblastic migration in partial necrosis. Migrating neuroblasts were found in neonatal cerebral cortex with hypoxic encephalopathy. A correlation existed with experimental data proving that MG neonatal cerebral cortex could be produced by neuroblastic migration through fields of partial necrosis. Group C: Detailed investigation concerned 4 neonates with MG due to hypoxic necroses- 2 cases with probable lesion of big vessels perfusion after thromboembolia and 2 cases with cortical vessels perfusion lesion in toxoplasmosis and rubella meningoencephalitis. Findings were compared with experimental MG and correlated with the data from group A and B. Results showed that the production of MG formations in neonatal brain (atypical irregular MG cortex, 4-layer-MG cortex, intracortical nodules, MG intracortical microsulci, neuronal protrusion into molecular layer and pia mater, intracortical and subcortical neuronal heterotopias) can be participated by neuroblastic migration in the transformation of injured immature cerebral cortex. Probable timing of various MG formations and of a relation of MG to ulegyria were presented.
An analysis of histotopographic sections from 31 neonatal brains with hypoxic periventricular necroses. Distribution and topography of necroses was traced in 7 frontal planes in correlation to frequency of impaired white matter tracts. Results were summarized in schemes. Another topic of analysis was morphology of a slight white matter impairment (spongiosis). Used three grade classification of slight white matter impairment contributed to morphologic criteria of neonatal hypoxic-ischemic encephalopathy. Having considered his own findings and data from literature the author decided a standard histological tissue sampling for perinatal encephalopathies.
Description of a database system for registration of biopsies in a IBM-PC (AT) compatible computer. The system enables simple registration of bioptic findings for needs of diagnosis, teaching, seminars, and research.
The author evaluated retrospectively the therapeutic effect of intravenous systemic thrombolysis by streptokinase in 24 patients with developing cardiogenic shock associated with myocardial infarction. Fourteen patients died while in hospital (58%) and 10 (42%) survived and were discharged after a suitable time in hospital. Serious arrhythmias were frequent already before thrombolysis (ventricular fibrillation 2X, AV block grade II and III 5X, atrial fibrillation 4X). After streptokinase administration in two patients ventricular tachycardia was recorded, twice significant ventricular extrasystoles and once AV block grade II. In none of the patients arrhythmia was the cause of death. No allergic reaction was recorded. One patient following cardiopulmonary resuscitation developed after thrombolysis haemorrhage into the chest wall from the site of injection into the subclavian vein, without further sequelae. Thirteen of the dead were subjected to necropsy which confirmed the clinical diagnosis: once a haemorrhagic infarction was found, once rupture of the heart with tamponade. In two instances coronary thrombosis was detected. Of the 10 discharged patients at the end of 1988 seven patients survived for a period of 1-8 years. From the described group it may be concluded that systemic thrombolysis in patients with developing cardiogenic shock associated with myocardial infarction is not associated with a higher incidence of side-effects and that in some of the patients with a very adverse prognosis, after streptokinase administration a change in the course of the disease occurred leading to improvement of the condition and discharge from hospital.
The authors present a group of three traumatic ruptures of the diaphragm and call attention to the possibility of this injury in blunt injuries of the chest or abdomen. In the diagnostic part they describe the complex character of diagnosis of rupture of the diaphragm even when modern non-invasive examination methods are used, some of which (CT) may give false positive results. The authors describe typical symptoms leading to the diagnosis.
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Of 1234 patients with confirmed myocardial infarction who were treated at the emergency medical service station in Ostrava in 95 (8%) circulatory arrest developed and cardiopulmocerebral resuscitation was applied. In 60 (63%) it was not possible to restore spontaneous circulation and they were subjected to necropsy after resuscitation efforts. A total of 35 (37%) of the resuscitated patients were taken to hospital. Resuscitation was permanently successful in 19 (20%) of patients with myocardial infarction. The authors discuss the most frequent shortcomings of urgent resuscitation as well as other possible ways how to improve the final results.